It is difficult to predict the future but foolish to ignore the past. The history of ambulatory anesthesia is one of many trends and societal or economic forces that have provided the impetus for the growth of the specialty. By understanding the events of the past one can have a greater understanding of the present and some insight into the possible trends of the future. Financial and societal forces will continue to drive the growth of ambulatory anesthesia. New technology, surgical techniques, and progress in anesthesiology will be financed and supported by society so long as ambulatory surgery continues to decrease the costs of health care. Although new technology may increase the direct costs of providing care in the operating room, the overall costs to society should be reduced by a decrease in lost productivity and individual suffering on the part of the patients. Regardless of future changes, the anesthesiologist must remain dedicated to the safety and comfort of the patient first and foremost. If that happens, then the future of ambulatory anesthesiology and surgery will continue to be bright.